Little respect for doctors

Laszlo Radvanyi radvanyi at
Wed Aug 13 16:47:13 EST 1997

On 7 Aug 1997, Selliott wrote:

> Brian Stapleton <star1190 at> wrote in article
> <5sb8jp$6rp$1 at>...
> > In Fritz Langley <efudd at> wrote:
> > 
> > > Furthermore, "shopping" for doctors has real practical limitations. 
> > > Rural areas are natural monopolies; there isn't demand for more than a
> > > very few practitioners.  In many cases it isn't possible at all to
> > > change providers when you're satisfied.  Many procedures are
> > > irreversible or otherwise unrepeatable; you can't try again if you're
> > > dissatisfied with the results.
> > 
> > Man! Ain't THAT the truth! The people who present for chonic care or
> > advanced disease are usually the people who could not afford preventative
> > medicine so are now in such an advanced state that they need procedures
> > that cost umpteen times the price that simple initial health care would
> > have avoided...
> > 
> > Sorry... I'm not a "commie" or a "pinko liberal", but paying for a new
> > engine because you didn't want to spend the money for a couple of quarts
> of
> > oil is simply bad budget management...
> > 
> > go figure...
> > 
> > 		  ******************************************
> > 		      The only thing you must understand 
> > 		  is that it is not necessary to understand, 
> > 				but to enjoy
> > 		  ******************************************
> > 
> I'm only grateful that I am undergoing my medical training in a country
> like Australia, because what I see of the American Medical system via ER
> and Chicago Hope and magazines such as Time make me totally amazed that a
> country as rich as the USA cannot look after its poor even slightly
> adequately.  We have private medical insurance but if we were unable to
> afford this, we could attend a government hospital with a waiting list of a
> couple of months.  When you have a baby in a public hospital, you stay in
> five days.  My friend who gave birth in LA had to be out in 24 hours!!  As
> a private obstetric patient here as I have been on three occasions, one is
> allowed to stay up to ten days.  Basically until you feel like going home.
> I find it amazing that people still believe that the USA is a great place
> to live.  Someone is obviously not telling them what it's like in other
> countries.
> We're even paid $550.00 per week for me to stay in med school and my
> husband to stay at home with our four children.
> My University fees are $1500.00 per year.  Still I guess you did win
> Operation Desert Storm and that's one of the important things in life isn't
> it!?
> Regards and sympathy
> Suzanne Elliott

I find it commendable that the Australian government takes this stance.  
This was (used to be) the situation in Canada.

Canada has a social medical system that works well because we here are 
willing to pay the higher taxes to fund a good gov't sponsored universal 
healthcare system.  Also, up until the 1990's university tuition fees were 
very cheap, even for medical students. 

However, you can not compare Australia's situation with the USA, nor can 
Canada compare its situation with the USA and sit on a high horse and 
ridicule the USA for its system.

Here are the facts:

1.  The Australian (and Canadian) population is less than one tenth of 
the American population.  Wealth is not as evenly spread out over the 
population in the USA as it is in Canada and Australia.

2.  Gov't social programs, including socialized medicine, have run up 
enormous national debts.  I'm sure Australia has not felt the big crunch 
that we Canadians are feeling now with a huge deficit.  I'm sure sooner 
or later you will feel it too and the gov't will cut back.  I'm sure 
future generations of medical students will not get payed money and have 
low tuition fees to go to school.  Part of that program may be a gov't 
initiative there to increase the number of doctors, especially in rural 

In Canada, tuition fees have increased enormously over the last few 
years- its the reality we have to face when there is simply a finite 
supply of money and you can't increase taxes anymore without destroying 
the economy.

3.  Countries are facing a constantly increasing pressure on their 
healthcare systems due to the aging of the population and increases in 
chronic diseases and cancer.  The system is beginning to develop large 
cracks in Canada and severe cutbacks and increased privatization are 
coming into effect.

4.  The USA is struggling to change their healthcare policies towards a 
more equitable form.  It will take some time until a new generation of 
Americans grows up with a better world view to force that change.  The 
HMO system presently operating has many problems.  However, we must view 
this as a first step towards a truly national program.  State gov'ts can 
easily step in at the right time and take over control of these already 
existing infrastructures and make them more universal and better for the 
population.  State taxes may need to increase.

5.  USA (the federal gov't) already spends more money on healthcare than 
any other country in the world for an already existing socialized program 
for the under-priveleged.  They simply can not afford to change 
over into a system such as Canada and Australia quickly- the gov't would 
go bankrupt.

6.  The USA (and Canada) is a very humanitarian country.  Part of the 
medical funding problem is that the country has absorbed tremendous 
numbers of immigrants over the last 30-40 years.  The USA has absorbed 
literally millions of people who go there for a chance at economic and 
political freedom.

7.  One negative point, however, is that a mistrust of gov't still 
pervades American society.  Afterall, most of the people who originally 
settled the USA and established its society and culture were religious 
and political (e.g. Quakers) from their own gov'ts in Europe.  Again, 
this situation has to improve.
8.  Canada's situation is not that hot also.  There are sometimes severe 
waiting lists for elective surgery (e.g., cardiac and transplants) due to 
cutbacks and there simply being not enough resources.  I'm sure this will 
eventual happen in Australia as your healthcare burden increases.  As we 
speak, dozens of hospitals are being closed in Ontario due to the lack of 
funding.  The tax money just can't cut it!

Overall, the system in the USA is far from optimal, but our's is far from 
perfect as well.  The USA is struggling to reform their system.  Give 
them a break.  Criticism is always easy from the outside- you don't live 
there.  It will take a while for a system that has been entrenched for 
over two hundred years to change.  But, the US will eventually change to 
a better more equitable system.

Laszlo G. Radvanyi
Research Associate
Bone Marrow Transplant Service
Ontarion Cancer Institute, Princess Margaret Hospital
Toronto, Ontario M5G 2M9

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